Skin Cancer—The Importance of Prevention FREEONLINE FIRST

Eleni Linos, MD, DrPH1; Kenneth A. Katz, MD, MSc, MSCE2; Graham A. Colditz, MD, DrPH3,4

[+] Author Affiliations

JAMA Intern Med. Published online July 26, 2016. doi:10.1001/jamainternmed.2016.5008

Text Size: A A A

Article

References

Comments

In 2009, the US Preventive Services Task Force (USPSTF) found insufficient evidence to recommend skin examinations for the early detection of skin cancer in adults. The conclusion followed from a systematic review of the effectiveness and harms of clinical visual skin examinations by physicians or patient self-examinations in terms of morbidity and mortality from skin cancer.

Several years later, after another systematic review,1 the USPSTF’s conclusion—that there is insufficient evidence to recommend total-body skin examination for the early detection of melanoma, basal cell cancer, or squamous cell cancer in all adults—remains the same.2

The USPSTF’s determination that evidence is not adequate to support a recommendation for skin cancer screening will likely once again disappoint national organizations such as the American Academy of Dermatology and the Skin Cancer Foundation, which have advocated for screening.3,4 Physicians and patients might also be confused. After all, several organizations have encouraged screening; skin cancer seems easy to detect early because it is visible; skin examinations are neither painful nor invasive; and melanoma thickness at the time of diagnosis predicts mortality.